Provider Demographics
NPI:1699290908
Name:PURE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PURE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBRZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-708-7877
Mailing Address - Street 1:1546A 75TH ST
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-6205
Mailing Address - Country:US
Mailing Address - Phone:630-708-7877
Mailing Address - Fax:
Practice Address - Street 1:1546A 75TH ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-6205
Practice Address - Country:US
Practice Address - Phone:630-708-7877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty